Health teams to conduct additional 200 tests every week for community surveillance

The Gurugram health department is likely to soon start a systematic community surveillance in order to monitor the spread of Covid-19 at the district level.

The Gurugram health department is likely to soon start a systematic community surveillance in order to monitor the spread of Covid-19 at the district level.

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The monitoring, officials said, will include testing outpatient attendees in identified health facilities and pregnant women for the virus. Every week, 200 samples will be collected in addition to the routine testing done in containment zones and individual cases being reported from different areas of the city.

“It is called district level facility-based surveillance for Covid-19. We will be selecting six public and four private healthcare facilities for community surveillance, as per government guidelines,” said Dr Jaswant Singh Punia, chief medical officer. He said that the health facilities will be identified by Friday after which testing will start.

As part of the surveillance, the health team will be covering both low and high-risk population groups. In the low-risk group, outpatient attendees, especially those without Influenza like Illness (ILI), and pregnant women will be covered. In the high-risk category, samples of health care workers and hospital staff will be taken.

Every week, 100 samples of health care workers will be collected, while 50 samples each of outpatient attendees and pregnant women will be taken adding up to 200 samples. “Every month at least 800 samples will be taken to check the spread of the infection,” said Punia.

Nasal and throat swabs will be collected for RT-PCR and blood samples will be collected for ELISA (Enzyme-Linked Immunosorbent Assay) for IgG antibodies. As per an order issued by the state health department, the IgG ELISA based testing to detect if a person has antibodies will replace RT-PCR based testing in subsequent rounds for surveillance purpose. Also, pool testing of samples will be done only for surveillance but not for the diagnosis of individual patients.

Rajeev Arora, additional chief secretary, health department, said,“The Central government has shared its guidelines for community surveillance. But Haryana has already been doing random testing to check spread of the infection. We will now be merging the state and the Central government guidelines and increase the surveillance base.”

Dr Preeti Kumar, vice president, Public Health Foundation of India (PHFI), said that community surveillance would aid in identifying areas where cases are high. “Mass testing of population is impossible due to operational issues and other technical factors. Sampling becomes extremely critical by doing proper size estimation. Separate containment strategies can be framed for areas with high number of cases while freeing others from lockdown restrictions.”

According to her, testing pregnant women becomes essential as they cannot be denied healthcare services, while those visiting OPDs having no ILI -like symptoms can be silent carriers. “During an epidemic, surveillance and sampling require extra vigilance,” said Kumar.

TESTING IN URBAN SLUMS

Continuing with its targeted sampling, the district health team is now focusing on urban slums. Surveillance and sample collection exercise was done in urban slums of the city such as Chakkarpur, Tigra and Ghata. In Chakkarpur, 252 people were tested for SARS-CoV-2 antibodies using Rapid Testing Kits (RTK) while 40 samples were taken for RT-PCR test. All the tests turned out to be negative.

Likewise, in slums of Tigra, 90 people were tested for antibodies and 60 for RT-PCR. In Ghata, 29 were tested for antibodies and 46 for RT-PCR. Punia said that the exercise in these areas will continue till Sunday. At least 128 samples were also taken from Khandsa Mandi, wholesale market for fruits and vegetable, where 25 vendors have tested positive so far.

According to the data shared by the state health department, 441 RT-PCR test and 341 antibody test have been done in the urban slums of the district, that house a population of more than 1 million . Out of which 2,56,866 households have been surveyed by ASHA workers since the beginning of the outbreak and 9,35,372 were screened for ILI and Severe Acute Respiratory Illness (SARI).

Data shows, 2992 people were found with ILI, breathlessness, pneumonia and SARI. None of them were found to be Covid-19 positive. While in other districts, like Jhajjar, 72 people in urban slums were tested Covid-19 positive. 16 were found positive in Faridabad, 14 in Panipat and 4 in Sonepat slums.